PERMFILE118626

• Permit No: M1987072
• IBM Index Class Name: Permit File
• Doc Date: 4/24/1987
• Doc Name: LIMITED IMPACT OPERATION 110 APPLICATION FORM
• Media Type: D
• Archive: No

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10. Corre<.,pondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
]ndividual's Name: A Stanley J. Conner
Company Name:
Street: i~s~ ennth nlarLgnn
City: Denver
State: Colorado Zip Code: 80210
Area Code: ;03 Telephone: 722_9095
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: ~,,~~
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: Sane
C~~mpany Name:
Street:
C•i ty:
S~.ate: Zip Code:
Area Code: Telephone:
11. Primar~~ future ^ Cropland(CR) Pastureland(PL) ^ General Agriculture(GA)
land use ^ Rangeland(RL) ~ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS)^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD)
12. Primary present ^ Cropland(CR) ~ Pastureland(PL) ^ General Agriculture(GA)
land use ^ Rangeland(RL) Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR)
To the best of my knowledge, all the information presented on this application form and
the attachec Exhibits A-G are true and correct (must be signed by applicant/operator).
Date: /~_L3.1937 BY: ~~; ,,~1~
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